Individual provider · Type 1 NPI
Elizabeth Davenport, LMT
Massage Therapist · Malta, ID
NPI number
1750963328
Active
Practice location
1503 E Highway 77
Malta, ID 83342-8627
Other practice locations
- 335 E Lewis St, Pocatello, ID 83201-6408 · (208) 244-0617
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist Primary | 225700000X | MA3224 (ID) |
Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
About NPI 1750963328
Elizabeth Davenport, LMT's National Provider Identifier is 1750963328, issued on Apr 23, 2021. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Malta, ID. The record was last updated on Apr 23, 2021.